Pericardial patch repair of an extensive longitudinal iatrogenic rupture of the intrathoracic membranous trachea.

An iatrogenic, longitudinal rupture of the membranous trachea, which extended from the thoracic inlet to 2.0 cm above the carina, was found intra-operatively, during the thoracic stage of a three-stage esophagectomy, in a female, 80-year-old patient. Tracheal rupture was the result of tracheal intubation with a 35-F double-lumen endotracheal tube. Tracheal rupture was successfully repaired by suturing a free pericardial patch at the edges of tracheal rupture, by application of BioGlue on the external patch surface and by covering tracheal repair with a pedicled serratus anterior muscle flap. The patient had a 25-day intensive care unit stay and video-bronchoscopy performed at the 25th postoperative day showed absence of granulation tissue formation and an acceptable tracheal lumen. The overall hospital stay was 83 days because of abdominal complications; no problems concerning the tracheal repair were observed during the prolonged postoperative period.